califalcon

Indeed!!! I am quite aware of such nurse./doctor imbalance. I believe that changes occur when examples are set.......such as our aeromedical certification program. But we are in the midst of creating an academy in Florida that will fundamentally serve the EMS and prehospital care needs of our Latinamerican counterparts bu we can also take those programs abroad and offer the incentive of a US certificate which could open some doors to change. I applaud your stamina and dedication to a profession that is so mistaken for maids or worse, Doctor's maids. New doctors should play nurse...and see what it really means. Let me know how we can help. I do know some major players in Ecuador........perhaps it's time to make such attitude change

Latin America hasl always been a third-world environment when it comes to medical care, not medicine. It is the cultural attitude that allows the apparent lack of caring or lack of cleanliness. But also is the lack of rural health care, education and resources. As an international educator in an area that in the US is considered the Elite....flight medicine, I have seen many changes in the last 15 years of traveling to Central and South America. Health care is improving mainly because people do have alternatives or perhaps, can afford to pay for hose basic needs like a stretcher with sheets, a bedside commode and curtains for privacy. I am sure a few hospitals in he US are also struggling to provide those simple items. But I will share a recent experience observed during a trip to Argentina to certify flight physicians. As I am being shown the beautiful sites of La Plata, the capital of the Province of Buenos Aires, we pass by he "General Hospital"; there is a line of people waiting outside, many sitting on he 10 steps leading up to he reception area. Food vendors all around and people holding bags with food and linen.......still waiting to be seen. Here is a country with advanced medicine, with surgeons who staff the UCLA and Stanford medical centers, yet still can not manage their local needs. If I were to be given the challenge to change something there, it would be to re-educate both care givers and patients...and show them how local free or sponsored clinics, would alleviate the problem of immediate health care. Those agencies offering such exposure to Lain American health care, do so not to improve the care, but to profit from he many souls who believe in giving while learning. I would love to hear comments and suggestions. You may visit our website as posted on our profile. Manny

I just wonder if Dr. Knope would know he effects of altitude....or run a vent in flight. Sure; MD's are qualified to practice medicine, but there is a reason why in he US, only Nurses and Paramedics, do EMS and in-flight care.

In 1992 before PanAm became defunct, I was returning from Hawaii. I was in first class and tthen I was allowed to take aborad my ACLS equipment. Two hours into the flight, a passenger suffered acute chest pain. The captain called for a "doctor" on board..........and three appeared. A dermatologist, an oral surgeon and another non-critical care specialist. The three of them fumbled and none of them appeared o know how to assess the patient. By that time I had my monitor on, and O2 a hand......and my ACLS box open and ready. I made my way to the patient with the paddles at the ready....ripped the man's shirt open and placed them on his chest..........saw severe bradycardia.........placed him on O2 and dispatched a dose of Atropine. Then kept him on the O2 and monitor. When the purser came over to disband the "observers", I introduced myself...and to the spouse of the patient who by now was stable and sat by him the rest of the way. Having the well earned "Doctor" does not guarantee you a life-saving person. It has no bearing on what your skills are. I was a flight nurse returning from delivering a CA patient to his home to die. I now deliver aeromedical certification courses all over Latinamerica........to Doctors...nurses and medics. Manny

Thanks for the contribution....no matter how small it may seem now, in the future (Longer transports like from europe to the US) are possible (in a limited way now) but that is our intent...to make it available worldwide. Manny (Califalcon)

Hello to all in the forum and thanks janfran for giving us the credibility. We had a meeting on Good Friday about the formation of this program. We have a bunch of people who for one reason or another had a hand in the development of high quality services but none could equal the scope of our new Mobile ECMO design. With a Lear 35 that will be redesigned for an FAA approved (STC) ECMO cart, equipped with the latest ECMO items, the idea lit up like a Christmas tree and now we have several equipment manufacturers interested not only in R and D for newer ideas and to redesign the machines to fit the Mobile EcmoJet, but to be the first to demo their items aboard the Jet. Investors are also looking at a very interesting business, but we are cautious about who we invite to the table. We need, a great team that could eventually be our partners/owners of this idea and we want to include Neonatologists, Neo nurses and RT's to become part of this program. We will be working with several foreign facilities, the US Air Force and many of the ECMO centers that with the absence of a committed Aeromedical service, sometimes are not able to help some of the kids in need......mainly because some of the ECMO centers (3 only) that have their own aircraft....limit their transports to their own patients. We will break the mold. thanks again...and if there are any ideas, questions or simple curiosity...please let us know. Manny

Hi to all: I am new to the forum but with a very extensive service as an RN both in military and civilian sections. ECMO started catching my interest when in 1995 I arranged for an ECMO transport from Kapiolani to Orange County California and had to deal with rearranging flights with the US Coast Guard because the ECMO unit would not fit in the Gulfstream we were using. The modality has grown considerably...the Air force at Wilford Hall, UM and Arkansas are the only known centers to do Mobile ECMO in the US. However, they self limit their transports to patients who are referred to their facilities or in the case of WHMC, to military and their dependents. I only know of two or three transports that were done externally. I have been in the aeromedical world since the beginning of the aeromedical development flying the injured under fire in a Huey and went on to develop my own aeromedical service and international development company. Now, after getting calls to transport ECMO patients and being basically refused by the current Mobile providers, I have contacted the Pentagon and received the assurance of support to develop and promote Mobile ECMO services that will also be used by the USAF .....without any hospital affiliation that will eliminate the need to search for the means to get a patient from one center to the other or deal with hospital politics. I will be very happy to hear what needs exist and what it is we need to do to plug the holes. We will be placing a LearJet in service for this....which will eliminate the need for large military cargo aircraft and imagine....minimize the costs to the taxpayers. thanks for the opportunity to participate in this forum Manny